Concussion and Nutrition in Professional-Level Collision Sports: Perspectives from Australian Sports Dietitians

Sports nutrition experts are commonly employed by professional collision sports teams to provide nutrition support to athletes, including guidance related to concussions and repeated head impacts. At present, there are limited clinical guidelines to base dietary advice regarding concussions, which may result in differing management approaches.

This study aimed to explore the practices and perspectives of sports dietitians working in professional-level Australian collision sports (Australian Rules Football, Rugby League, and Rugby Union) regarding nutrition strategies for concussion management.

Online semi-structured interviews were conducted with 14 Accredited Sports Dietitians. A qualitative descriptive methodological approach guided data collection and analysis, with structured content analysis used to identify key categories. Quantitative summaries of supplement practices were also reported.

Five categories were identified: 1) the dietitian's role in concussion management:dietitians considered themselves integral to multidisciplinary concussion management and were primarily involved after concussion; 2) nutrition strategies for concussion and brain health: which included dietary adjustments to manage symptoms and supplementation with fish oil and creatine monohydrate (93% of participants) to mitigate potential neurological sequelae; 3) confidence in management of concussion: dietitians felt confident in recommending strategies for concussion that were commonly used for other indications (e.g., creatine monohydrate supplementation for performance enhancement) but were less certain when providing tailored/individual recommendations, particularly in complex cases; 4) barriers to and enablers of recommendations: that spanned from individual level (e.g., symptoms affecting dietary intake) to organizational level (e.g., financial resourcing to support supplementation protocols); and 5) differences in care between squads and codes: in female and academy squads compared with their professional-level male counterparts.

Sports dietitians in Australian collision sports actively contribute to concussion management, despite limited clinical guidelines. Further clinical research and the development of evidence-informed guidelines are critical to enhance the integration of nutrition into multidisciplinary concussion management and ensure optimal recovery for athletes.